Saturday, June 26, 2010

I've written extensively in the past regarding the benefits of eccentric exercises for rehabilitation of a variety of overuse injuries.

But I also feel strongly that eccentric leg exercises are very valuable in strength training for runners who may have biomechanical limitations in regard to training volume. I will commonly reduce training volumes in athletes with these concerns and replace some training with eccentric exercises to increase the durability in the muscles crucial for running. Note that most of these exercises were developed to fix chronic tendinopathy. In this use, returning the limb to neutral by the uninjured limbs is important. This isn't the case in using the eccentric training for increasing run durability.

My routine includes strengthening the following muscles:1. Hip Abductors (gluteals)

The pelvic drop exercise is completed by standing on a step with the exercised leg, while holding onto a wall or stick if necessary for support. With both knees locked, the opposite, noninvolved pelvis was lowered towards the floor. Then, the suspended leg is lowered even further by bending the supporting leg. Finally, the suspended leg swivels and goes through the swing phase of gait by first swinging forward then backwards while the exercised leg stabilized the body by contracting the gluteus medius on that side.

The reference used below describes a different exercise but supports eccentric strengthening for ITB syndrome.

2. Knee Extensors (Quadriceps)

Place your feet shoulder-width apart on an decline board. Lower yourself while standing on the knee intended for exercise (bend the knee approximately 60 degrees), then raise yourself while standing on the opposite knee. Build up to three sets of ﬁfteen repetitions, twice a day. You can add dumbells to increase weight as you progress.

3. Calf Muscles (Gastrocsoleus)

Stand with all your body weight on the exercised leg. From an upright position and standing with all body weight on the forefoot, with the heel extended off the back of a step, the calf muscle is loaded by having lowering the heel beneath the step. The foot is then brought back to neutral with either the use of both ankles. In rehabbing injured ankles, non-injured leg is used to return to the starting position.

********The eccentric strengthening of the muscles allow them to be more resistant to the destruction we see during race efforts and hard running.

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Bio

Dr. Shilt is the Director of Gait Lab at St. Luke's Childrens Hospital in Boise, Idaho. After nearly 10 years in academic medicine as the residency program director and an Assoc. Professor at Wake Forest University, he transitioned to his current position that allows both the practice of Adult & Pediatric Orthopaedics as well as the expansion of his practice in Endurance Sports Medicine. He has given over 100 presentations internationally, authored more than 30 articles, 5 chapters and has been the primary or co-investigator on research grants totaling more than $1 million. He co-authored a chapter in Joe Friel and Gordo Byrn's book, Going Long. He is currently working with Team Exergy, a professional cycling team based in Boise, ID. Dr. Shilt has qualified for the world Ironman Championship in Hawaii, Xterra World Championship in Maui, ITU Age Group World Championship, the Boston Marathon, and won the coveted "big buckle" at the Leadville 100 Mountain Bike Race.
Dr. Shilt has been chosen as one of the "Best Doctors in America" a distinction only 4% of all physicians in the United Stages are selected.